A comparison of the use of Trachlight® and Eschmann multiple-use introducer in simulated difficult intubation

Harvey, K.; Davies, R.; Evans, Alan W.; Latto, I. P.; Hall, Judith Elizabeth

doi:10.1097/00003643-200701000-00013

Cited by 14 publications

(2 citation statements)

References 33 publications

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“…This prominent position of the tracheal tube introducers in the management of the difficult airway is not reflected by the volume of research on the effectiveness of the newly introduced devices. The Eschmann multiple-use introducer has been extensively evaluated in patient [1,8,13,[19][20][21][22][23][24] and manikin studies [10][11][12]25].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of tracheal tube introducers in simulated difficult intubation*

Janakiraman¹,

Hodzovic

Reddy

et al. 2009

Anaesthesia

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SummaryIn a randomised cross-over study, 72 anaesthetists attempted to place Pro-Breathe, new Portex, and Frova single-use tracheal tube introducers and an Eschmann multiple-use introducer in the trachea of a manikin set to simulate a grade 3 laryngeal view. Successful placement (proportion, 95% confidence interval) of either the Frova (78%, 67-86%) or the Eschmann introducer (64%, 52-74%) was significantly more likely (p < 0.0001) than with the Pro-Breathe (4%, 1-12%) or the new Portex introducer (13%, 7-22%). The difference between the success rates for the Frova and the Eschmann introducers (p = 0.08) was not significant. A separate experiment revealed that the peak force that could be exerted by the Pro-Breathe, new Portex and Frova single-use introducers were three to six times greater than that which could be exerted by the Eschmann introducer (p < 0.0001). The single-use introducers are more likely to cause tissue trauma during placement, particularly if held close to the tip.

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Section: Discussionmentioning

confidence: 99%

Evaluation of tracheal tube introducers in simulated difficult intubation*

Janakiraman¹,

Hodzovic

Reddy

et al. 2009

Anaesthesia

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“…The conventional lightwand intubation technique has been previously reported to have an initial success rate approximately 80% [10]. To detect a statistically significant difference between the two groups, we hypothesized that a minimum difference of 15 percentage points would be necessary.…”

Section: Discussionmentioning

confidence: 99%

Comparison of lightwand intubation technique in neck-immobilized patients with face-to-face and conventional approaches

2024

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The lightwand is a valuable device for managing the airways of patients with neck immobilization due to its ease of minimal neck movement. For lightwand intubation, adopting a face-to-face technique offers the potential for improved accessibility and reduced risk of injury associated with blind scooping maneuvers. In this study, we compared the initial success rate of the face-to-face approach with the conventional method as the primary endpoint and their complications as the second endpoint, including postoperative sore throat, the incidence of bleeding and hoarseness in neck-immobilized patients. Our findings indicate that the initial success rate was 84.1% for the face-to-face approach and 88.6% for the conventional approach (p = 0.381). The intubation times for the face-to-face approach and conventional approach were 12.0 and 14.0 seconds, respectively (p = 0.704). Furthermore, there were no statistically significant inter-group differences observed in the overall incidence of postoperative complications, including sore throat, bleeding and hoarseness. In summary, our study shows that the face-to-face approach in lightwand intubation for neck-immobilized patients could be suggested as one of the alternatives, yielding outcomes similar to the conventional lightwand technique.

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The difficult airway with recommendations for management – Part 1 – Difficult tracheal intubation encountered in an unconscious/induced patient

Law

Broemling²,

Cooper³

et al. 2013

Can J Anesth/J Can Anesth

329

260

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BackgroundPreviously active in the mid-1990s, the Canadian Airway Focus Group (CAFG) studied the unanticipated difficult airway and made recommendations on management in a 1998 publication. The CAFG has since reconvened to examine more recent scientific literature on airway management. The Focus Group’s mandate for this article was to arrive at updated practice recommendations for management of the unconscious/induced patient in whom difficult or failed tracheal intubation is encountered. MethodsNineteen clinicians with backgrounds in anesthesia, emergency medicine, and intensive care joined this iteration of the CAFG. Each member was assigned topics and conducted reviews of Medline, EMBASE, and Cochrane databases. Results were presented and discussed during multiple teleconferences and two face-to-face meetings. When appropriate, evidence- or consensus-based recommendations were made together with assigned levels of evidence modelled after previously published criteria.ConclusionsThe clinician must be aware of the potential for harm to the patient that can occur with multiple attempts at tracheal intubation. This likelihood can be minimized by moving early from an unsuccessful primary intubation technique to an alternative “Plan B” technique if oxygenation by face mask or ventilation using a supraglottic device is non-problematic. Irrespective of the technique(s) used, failure to achieve successful tracheal intubation in a maximum of three attempts defines failed tracheal intubation and signals the need to engage an exit strategy. Failure to oxygenate by face mask or supraglottic device ventilation occurring in conjunction with failed tracheal intubation defines a failed oxygenation, “cannot intubate, cannot oxygenate” situation. Cricothyrotomy must then be undertaken without delay, although if not already tried, an expedited and concurrent attempt can be made to place a supraglottic device.

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A comparison of the use of Trachlight® and Eschmann multiple-use introducer in simulated difficult intubation

Cited by 14 publications

References 33 publications

Evaluation of tracheal tube introducers in simulated difficult intubation*

Evaluation of tracheal tube introducers in simulated difficult intubation*

Comparison of lightwand intubation technique in neck-immobilized patients with face-to-face and conventional approaches

The difficult airway with recommendations for management – Part 1 – Difficult tracheal intubation encountered in an unconscious/induced patient

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